The objective of this proposal is to evaluate chronic kidney disease (CKD) as a risk factor for stroke, cognitive impairment and brain magnetic resonance imaging (MRI) findings of cerebrovascular disease, and to describe the relationships among traditional and non-traditional cardiovascular disease (CVD) risk factors and these cerebrovascular outcomes in individuals with CKD. CKD, stroke and cognitive impairment are all important public health problems in the United States, especially in the elderly; however, little is known about the manifestations of or risk factors for cerebrovascular disease in CKD. The principal investigator will utilize 2 data sources: the CKD in Pooled Populations (CIPP) Study, a dataset of 28,000 subjects compiled from 4 NHLBI-funded population-based cohorts with extensive data on estimated glomerular filtration rate (GFR), traditional CVD risk factors and stroke outcomes; and the Nutrition and Memory in the Elderly (NAME) Study, an ongoing, NIA-funded cross-sectional investigation of 1,650 elderly individuals with extensive data on estimated GFR, microalbuminuria, traditional and non-traditional CVD risk factors, and, in 550 subjects, MRI. Specific aims utilize 1) the CIPP Study to evaluate the relationships of CKD and traditional CVD risk factors with stroke outcomes as well as evaluate how these risk factors change over time; and 2) the NAME Study to evaluate the relationships among CKD, traditional and non-traditional CVD risk factors, stroke, cognitive impairment, and MRI findings. These two resources provide unique and complementary opportunities with a sufficient number of subjects to examine the study aims. The principal investigator will have completed a clinical and research fellowship in Nephrology and a Masters of Science program in Clinical Research, and he has been offered a faculty position as an Assistant Professor. He already has an exceptional record of publications in CVD epidemiology. In this proposal, he has developed a training program and research project that will provide him with the skills, experience and opportunities to develop as an independent investigator. He has already worked extensively with the databases, which are appropriate for the proposed analyses. He has assembled a multidisciplinary team with excellent mentors in an exemplary clinical research environment in order to accomplish the aims of this proposal and develop as an independent clinical researcher.